Introduction to Animal Physiotherapy: Difference between revisions

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== Introduction ==
== Introduction ==
Physiotherapy is defined as the therapeutic use of physical agents/means (i.e., massage or exercises) to treat disease/injury. This has been shown to be an extremely useful adjunct to medicine, human and veterinary.<ref>McGowan CM, Stubbs NC, Jull GA. Equine physiotherapy: a comparative view of the science underlying the profession. Equine veterinary journal. 2007 Jan;39(1):90-4.</ref> The primary purpose is to restore mobility/function and quality of life to patients. Oftentimes, this is done by stimulating the healing process to restore injured tissues, to improve the balance/strength of the injured tissues and stabilising the cardiorespiratory, neurological and musculoskeletal systems. Physiotherapy also has an important role in optimising performance and injury prevention in sporting and working animals. It can be performed on any animal, but the vast majority of cases seen in small animal practice are dogs.<ref>Hayes-Davies D. Physiotherapy for the sporting dog. Companion Animal. 2014 Aug 2;19(8):415-22.</ref>
Physiotherapy is defined as the therapeutic use of physical agents / means (i.e. massage or exercises) to treat disease / injury. This has been shown to be an extremely useful adjunct to medicine, human and veterinary.<ref>McGowan CM, Stubbs NC, Jull GA. Equine physiotherapy: a comparative view of the science underlying the profession. Equine veterinary journal. 2007 Jan;39(1):90-4.</ref> The primary purpose of physiotherapy is to restore mobility / function and quality of life to patients.


[[File:PA dog walking.jpg|center|thumb|422x422px]]  
This is often done by stimulating the healing process to restore injured tissues, to improve the balance / strength of the injured tissues and to stabilise the cardiorespiratory, neurological and musculoskeletal systems. Physiotherapy also has an important role in optimising performance and injury prevention in sporting and working animals. Animal physiotherapy is an emerging field<ref name=":0">McGowan CM. Introduction. In: McGowan CM, Goff L editors. Animal Physiotherapy: Assessment, Treatment and Rehabilitation of Animals. Wiley-Blackwell, 2016. p.1-2</ref> and it can be performed on any animal, but the vast majority of cases seen in small animal practice are dogs.<ref>Hayes-Davies D. Physiotherapy for the sporting dog. Companion Animal. 2014 Aug 2;19(8):415-22.</ref>[[File:PA dog walking.jpg|center|thumb|422x422px]]
== Dogs and Horses as Model of Human Physiotherapy ==
Human physiotherapy is based in some instances on research performed on animals. So to say "human" physiotherapy is not translatable to animals is flawed when the evidence was translated to human practice from animals.


== Human-Animal Dyad ==
== History ==
The first record of animal physiotherapy being practised comes from 1939 when Lord Mountbatten asked the Royal physiotherapist, Sir Charles Strong, to treat his horses.<ref name=":1">Van Der Walt, A. Introduction to Animal Physiotherapy Course. Physioplus, 2021.</ref> Work in this field evolved from this point on. The first official animal physiotherapy association, the Association of Chartered Physiotherapists in Animal Therapy (ACPAT), was formed in the United Kingdom in 1985<ref>Veenman P. Animal physiotherapy. Journal of Bodywork and Movement Therapies. 2006; 10(4): 317-27.</ref> and in 2011, animal physiotherapy was recognised as an official subgroup of the World Confederation of Physical Therapy (WCPT).<ref name=":1" />
 
== Transferring knowledge of human physiotherapy to other species ==
In order for physiotherapists to be able to successfully transfer their assessment and treatment skills to animals, there must be sufficient similarities in structure, function and physiology across species.<ref name=":1" /> There is a growing evidence base to support the notion that these similarities exist. For example:
* It has been found that the disease progression of osteochondrosis is similar in humans, horses and pigs. There are similar:<ref>McCoy AM, Toth F, Dolvik NI, Ekman S, Ellermann J, Olstad K et al. Articular osteochondrosis: a comparison of naturally-occurring human and animal disease. Osteoarthritis Cartilage. 2013; 21(11): 1638-47.</ref>
** Clinical presentations
** Changes on MRI and x-ray
** Histological appearance of the end-stage lesion
** Locations affected
* Spontaneous canine cancers have a similar pathophysiology and clinical presentatison to the equivalent human cancers<ref>Schiffman JD, Breen M. Comparative oncology: what dogs and other species can teach us about humans with cancer. Philos Trans R Soc Lond B Biol Sci. 2015; 370(1673): 20140231.</ref>
Moreover, some knowledge relevant to human physiotherapy has come from animal research. Horses are considered to be appropriate models for research on osteoarthritis of the knee.<ref name=":1" /> Dogs are the animal model of choice for total hip joint replacements.<ref>Skurla CP, Pluhar GE, Frankel DJ, Egger EL, James SP. Assessing the dog as a model for human total hip replacement. Analysis of 38 canine cemented femoral components retrieved at post-mortem. J Bone Joint Surg Br. 2005; 87(1): 120-7</ref>
 
== The Role and Scope of Animal Physiotherapists ==
Animal physiotherapy is continuing to grow and develop as a profession. Animal physiotherapists work alongside a multidisciplinary team, just as they do in human physiotherapy. However, in most countries, animal physiotherapists do not have first-line practitioner status. They generally work on referral from a veterinarian.<ref name=":0" /> Thus, there is a legal obligation to communicate with the veterinarian who is in charge of managing the patient.
 
There also needs to be a positive relationship with the animal’s carers. In the case of horses, this may be a large group, including the horse’s owner, rider, trainer, riding instructor, grooms and stableyard manager. There tends to be fewer carers involved in small animal care, but it is still important that each carer’s role in looking after the pet is understood.<ref name=":1" />
 
NB: There are different legal frameworks for animal physiotherapy across the world. If you are interested in this area of practice, it is essential to understand the legal requirements to practise this sort of physiotherapy in your country.<ref name=":1" />
 
Physiotherapy can be beneficial for animals with a wide range of conditions. It is often indicated post-operatively to correct complications that can occur as a result of surgery. The demand for post-operative animal physiotherapy has kept pace with the growing number of surgical options for small animal patients.<ref name=":0" />
 
Like conventional physiotherapy, animal physiotherapy is divided into a wide variety of specialities. In veterinary medicine, the divisions are:<ref>Price H. Introduction to veterinary physiotherapy. Companion Animal. 2014; 19(3): 130-3.</ref>
* Musculoskeletal
* Respiratory
* Orthopaedics
* Neurological
* Sports medicine
* Elderly care / geriatrics
 
=== Musculoskeletal ===
Most people consider this as 'traditional physiotherapy'. The conditions seen can be split into soft-tissue injuries, such as sprains / strains or ruptures of ligaments, tendons or muscles; bursitis and bone or joint disease, such as osteochondritis dissecans. The injuries may be a result of either a traumatic event or overuse, where the owner cannot recall the specific onset of symptoms.<ref>Goff L, Crook T. Physiotherapy assessment for animals. Animal physiotherapy, assessment, treatment and rehabilitation of animals. UK: Blackwell Publishing. 2007 Jan 1:136-63.</ref>
 
=== Respiratory ===
This encompasses the acute care of animals in a hospital, specifically for:
* post-anaesthetic recovery
* ventilated animals
Physiotherapy aims at managing secretions, preventing pressure sores, preventing atelectasis, reducing the work of breathing and optimising the ventilation / perfusion ratio to ensure high oxygen saturation levels.<ref>Rivière S. Physiotherapy for cats and dogs applied to locomotor disorders of arthritic origin. Veterinary Focus. 2007;17(3):32-6.</ref>
 
These aims are achieved through positioning (for pressure relief, postural drainage or to influence ventilation / perfusion ratio within the lungs), manual techniques such as percussion or vibrations to remove secretions, neuromuscular techniques such as rib springing to increase lung capacity and manual hyperinflation or bagging to improve ventilation and to aid secretion removal.
 
=== Orthopaedics ===
Physiotherapy following surgery is used to maximise the success of the surgery. By working with the surgeon, the recovery can be optimised. Orthopaedic surgeons may have their own protocols for rehabilitation following surgery and knowledge of these protocols is needed by the owner and therapist before embarking on a rehabilitation programme. These protocols guide the therapist on how much weight can be put through the leg and when different exercises can be introduced.<ref name=":2">Colveiro AC, Rauber JS, Ripplinger A, Wrzesinski M, Schwab ML, Pigatto A, Ferrarin DA, Mazzanti A. Neurological and Orthopedic Diseases in Dogs and Cats Submitted to Physiotherapy. Acta Scientiae Veterinariae. 2020 Oct 13;48.</ref>
 
=== Neurological ===
Neurological physiotherapy refers to the rehabilitation of animals following a neurological injury, which can involve a single limb or the whole body. Neurological damage can be managed conservatively or surgically. It may completely resolve or can leave lasting damage.<ref name=":2" />


== The Role of Physiotherapists and The Scope of Physiotherapy to Animals ==
The amount of initial damage usually has a significant impact on the ultimate recovery. Long-term solutions to permanent damage sometimes have to be sought, such as using wheels, harnesses / splints, to support the animal's everyday activities.
Physiotherapy is often used to correct complication that maybe occurred as a result of surgery; however, if introduced early and appropriately, these complications can be avoided in most instances. The rehabilitation must be of the highest standard to fulfil the expectation of the animal owners and veterinarian alike.


Physiotherapy can be beneficial for animals in a wide range of conditions. Conventionally, physiotherapy is divided into a wide variety of specialities. In veterinary medicine, the divisions are as followed: Musculoskeletal, respiratory, orthopaedics, neurological, sports medicine, elderly care/geriatrics.<ref>Price H. Introduction to veterinary physiotherapy. Companion Animal. 2014 Mar;19(3):130-3.</ref>  
=== Sports medicine ===
The preparation of an animal for athletic activity is extremely important and requires physical training, skill training and cardiovascular training. Modalities that reduce recovery time and encourage a return to full fitness are considered vital to protect what are considered “valuable assets”.<ref>Doyle A, Horgan NF. Perceptions of animal physiotherapy amongst Irish veterinary surgeons. Ir Vet J. 2006; 59(2): 85-89. </ref>


==== Musculoskeletal ====
Animal physiotherapists can help to guide owners on conditioning programmes that are both sports- and animal specific. Different sports will place very different demands on animals. For instance, the endurance capability of a sled dog is very different to the speed of a racing greyhound. The rehabilitation of sports injuries is also extremely important as often these animals are not lame, but subtle changes in muscle tightness can affect their performance.
Most people consider this as 'traditional physiotherapy'. The conditions seen can be split into soft-tissue injuries, such as sprains/strains or ruptures of ligament, tendon or muscle; bursitis and bone or joint disease, such as OCD. The injuries may be a result of either a traumatic event or overuse, where the owner cannot recall the specific onset of symptoms.<ref>Goff L, Crook T. Physiotherapy assessment for animals. Animal physiotherapy, assessment, treatment and rehabilitation of animals. UK: Blackwell Publishing. 2007 Jan 1:136-63.</ref> 
==== Respiratory ====
This is the acute care of animals in a hospital; it could be post-anaesthetic recovery or ventilated animals. Physiotherapy is aimed to manage secretion, prevent pressure sores, prevent atelectasis, reduce the work of breathing and optimise the ventilation/perfusion ratio to ensure high oxygen saturation levels.<ref>Rivière S. Physiotherapy for cats and dogs applied to locomotor disorders of arthritic origin. Veterinary Focus. 2007;17(3):32-6.</ref>


These aims are achieved using positioning (for pressure relief, postural drainage or to influence ventilation/perfusion ration within the lungs), manual techniques such a percussion or vibrations to remove secretions, neuromuscular techniques such as rib springing to increase lung capacity and manual hyperinflation or bagging to improve ventilation and aid secretion removal.  
=== Elderly care / geriatrics ===
As pets (and owners) are living longer, there are increasing numbers of arthritic animals presenting for treatment. These animals often have other co-morbidities, such as diabetes, that can complicate the rehabilitation process. <ref>Cottriall S. The geriatric canine and physiotherapy. Companion Animal. 2014; 19: 296-300. </ref> A holistic management approach will help to ensure that these animals can stay comfortable and functional for longer.


==== Orthopaedics ====
=== Developmental problems ===
Physiotherapy following surgery is used to maximise the success of the surgery. By working with the surgeon, the recovery can be optimised. Orthopaedic surgeons may have their own protocols for rehabilitation following surgery and knowledge of these protocols is needed by the owner and therapist before embarking on a rehabilitation programme. These protocols guide the therapist on how much weight can be put through the leg and when different exercises can be introduced.<ref>Colveiro AC, Rauber JS, Ripplinger A, Wrzesinski M, Schwab ML, Pigatto A, Ferrarin DA, Mazzanti A. Neurological and Orthopedic Diseases in Dogs and Cats Submitted to Physiotherapy. Acta Scientiae Veterinariae. 2020 Oct 13;48.</ref>
A large number of young animals are seen with genetic / developmental problems, and they benefit greatly from physiotherapy to support their joints. Conditions such as hip and elbow dysplasia are often seen. Physiotherapy, including hydrotherapy,<ref>Preston T, Wills AP. A single hydrotherapy session increases range of motion and stride length in Labrador retrievers diagnosed with elbow dysplasia. The Veterinary Journal. 2018; 234: 105-10.</ref> can improve their quality of life and prevent further problems or surgeries such as total hip replacements.


==== Neurological ====
== Evidence to Support the Use of Physiotherapy in Animals ==
Neurological physiotherapy is the rehabilitation of the animal following a neurological injury, which can involve a single limb or whole body. Neurological damage can be managed conservatively or surgically and may completely resolve or can leave lasting damage.<ref>Colveiro AC, Rauber JS, Ripplinger A, Wrzesinski M, Schwab ML, Pigatto A, Ferrarin DA, Mazzanti A. Neurological and Orthopedic Diseases in Dogs and Cats Submitted to Physiotherapy. Acta Scientiae Veterinariae. 2020 Oct 13;48.
While there are not many well-designed studies to support the use of physiotherapy in animals, massage is one area that has been researched in more detail. It has been proposed that due to similarities in physiology and anatomy between humans and dogs and cats, massage may also benefit animals:<ref>Corti L. Massage therapy for dogs and cats. Top Companion Anim Med. 2014; 29(2): 54-7. </ref>
</ref>  
* Manual lymph drainage has been found to reduce experimentally-induced lymphoedema in rats when compared to a control group<ref name=":1" />
* Massaging the caudal thigh muscles of horses increases range of motion when compared to a sham treatment<ref>Hill C, Crook T. The relationship between massage to the equine caudal hindlimb muscles and hindlimb protraction. Equine Vet J Suppl. 2010; (38): 683-7. </ref>
* The use of relaxing massage may help to calm and relax racehorses and improve race performance<ref>Kowalik S, Janczarek I, Kędzierski W, Stachurska A, Wilk I. The effect of relaxing massage on heart rate and heart rate variability in purebred Arabian racehorses. Anim Sci J. 2017; 88(4): 669-77. </ref>


The amount of initial damage usually has a significant impact on the amount of recovery that can be achieved. Long-term solutions permanent damage sometimes have to be sought, such as wheels, harnesses/splints, to support the animal's everyday activities.
== Differences between humans and animals ==
==== Sports medicine ====
Despite the similarities between humans and animals discussed above, there are also important differences (i.e. quadruped vs biped). It is important to understand the comparative anatomy and biomechanics of each species in order to determine the best treatment option.<ref name=":1" /> 
The preparation of an animal for athletic activity is extremely important requiring physical training, skill training and cardiovascular training. Physiotherapy can help guide owners on appropriate conditioning programmes for certain sports and specific to the animal being trained. Different sports will place very different demands on animals. For instance, the endurance capability of a sled dog opposed to the speed of a racing greyhound. The rehabilitation of sports injuries is also extremely important as often these animals are not lame but subtle changes in muscle tightness can affect their performance.  


==== Elderly care/geriatrics ====
Pathogenesis can be different even in shared pathologies or dysfunctions:
As pets (and owners) are living longer now, there is a high population of arthritic animals seen in clinics, they can often have other co-morbidities such as diabetes that can complicate the rehabilitation process. The provision of a holistic approach to managing these animals, will mean that they can stay comfortable and functional for longer.  
* In humans, cruciate ligament ruptures are an acute injury more common in athletes, but in dogs they are the result of chronic disease processes.<ref>Griffon DJ. A review of the pathogenesis of canine cranial cruciate ligament disease as a basis for future preventive strategies. Vet Surg. 2010; 39(4): 399-409. </ref> Therefore, post-operative rehabilitation occurs in the context of chronic deconditioning<ref name=":1" />
==== Developmental problems ====
* In humans, there are dynamic fluctuations in intervertebral disc disease, but in dogs (particularly chondrodystrophic (i.e. short legged phenotype) dogs like dachshunds), the disc calcifies and if disc material extrudes, surgery is almost always recommended<ref name=":1" />
A large number of young animals are seen with genetic/developmental problems, and they benefit greatly from physiotherapy to support their joints. Conditions such as hips and elbow dysplasia are often seen. Physiotherapy can improve their quality of life and prevent further problems or surgeries such as total hip replacements.
== The Benefits of Physiotherapy to Animals ==
Physiotherapy can be beneficial to all animals, however, the choice of treatment can be limited by any concurrent disease or illness. The behaviour of an animal, the level of understanding of the owner and their emotions can all influence the success of the physiotherapy treatment.


For instance, a nervous owner will unsettle the animal causing it to become tense which can adversely affect the examination and subsequent treatment session. The objective of physiotherapy is for the animal and the owner to be part of the treatment and it therefore must be at least stressful experience for both of them as possible. The objectives of a rehabilitation programme are to reduce pain, restore movement, improve gait, increase muscle strength and improve function. From these broad objectives, the formation of a rehabilitation programme will be tailored to suit an individual's situation and take into account the many factors that influence rehabilitation.  
== Human-Animal Dyad ==
The human-animal dyad refers to the relationship between a human caregiver and the animal. This can mimic a parent-child relationship. The dog–human attachment bond, for instance, is said to include all four features of attachment bonds that arise in human caregiver–infant relationships:<ref>Payne E, Bennett PC, McGreevy PD. Current perspectives on attachment and bonding in the dog-human dyad. Psychol Res Behav Manag. 2015; 8: 71-9. </ref>
* Proximity seeking
* Separation related distress
* Safe-haven effect
* Secure base effect
When assessing animal patients, it is important to remember that all of the information about an animal comes directly from the owner, even when using validated pain measures. The carer's own personality traits and emotions can have a significant impact on the animal.<ref name=":1" />


The knowledge of the health process can help maximise the strength of healing tissues following injury and prevent complications arising from the healing process. The is achieved by giving appropriate physiotherapeutic interventions at an appropriate time. The examination of an animal will help identify not only the injury act it has been referred to physiotherapy for but also any compensations that have occurred as a result for hat injury. The physiotherapist will also assess the animal's conformation and posture as this is the cornerstone for good movement. A poor conformation can tighten muscles and chronically tight muscles can alter bone alignment, which in turn can complicate rehabilitation.  
In the context of chronic pain, neuroticism is associated with pain catastrophising and higher pain-related anxiety. If animal cares are unable to modulate their own stress levels, they are more likely to catastrophise about their animal’s pain levels or disability.<ref name=":1" /> Pain neuroscience education for the owner, therefore, plays an important role in treatment of the animal.<ref name=":1" />


Understanding movement, posture and confirmation mean the animal will be treated holistically and this can improve the long-term prognosis for an animal. When treating animals, it is very important to educate the owners on how they can help the rehabilitation process, through a home exercise programme and self-management strategies. It is important to understand the clients' expectations of physiotherapy and their goals/aims for the animal. Physiotherapy treatment at the appropriate time will often promote the safe return to function or activity at the earliest time.  
In the case of horses, research shows that there is a high degree of emotional contagion. Emotional contagion is defined as: “the phenomenon of an automatic adoption of an emotional state of another person”.<ref>Singer T, Tusche A. Understanding others: brain mechanisms of theory of mind and empathy. In: Glimcher PW, Fehr E editors. Neuroeconomics: Decision making and the brain. London: Elsevier, 2014. p.513-32</ref> In the context of animal physiotherapy, it refers specifically to the animal reflecting the emotional state of conspecifics (a member of the same species), or of other animals / individuals in their environment.<ref name=":1" /> Horses have been found to demonstrate emotional contagion when observing human-horse interactions.<ref>Trösch M, Pellon S, Cuzol F, Parias C, Nowak R, Calandreau L et al. Horses feel emotions when they watch positive and negative horse-human interactions in a video and transpose what they saw to real life. Anim Cogn. 2020; 23(4): 643-53.</ref>


In elderly patients or this those with a chronic problem, an ongoing physiotherapy programme will maintain the function of an animal for as long as possible. It is particularly useful in these cases to educate the owner on adaptations that can be made in the home environment to support their animal, such as the provision of rugs on slippery floors and placing the animal's bed out of drafts to ensure they do not get cold and stiffen up overnight.  
Understanding these relationships, as well as having an awareness of animal behaviour enables the physiotherapist to approach and handle animal patients in a safe and effective way.<ref name=":1" />


Physiotherapists are trained to conduct specific and progressive rehabilitation programmes based on evidence-based treatments. By setting goals throughout the treatment process, the owner and therapist can monitor the progress of the animal towards the completion of treatment. Physiotherapy is used to maintain soundness in competition animals by training owners to be able to recognise signs of reduced performance and educating them on warm-ups or stretches for their animals. The provision of competition-specific conditioning programmes for athletic animals will help to prevent injury.
== Summary ==
* Animal physiotherapy is growing as a profession
* Research is limited at present, but there is evidence of sufficient interspecies similarities to support the use of human techniques on animals
* Physiotherapy can be beneficial to all animals, but the choice of treatment can be limited by the presence of co-morbidities
* The behaviour of an animal, the level of understanding of the owner and their emotions can all influence the success of the physiotherapy treatment


== References  ==
== References  ==

Revision as of 10:21, 2 January 2021

Original Editor - Alan Jit Ho Mak Top Contributors - Alan Jit Ho Mak, Jess Bell, Tarina van der Stockt, Lucinda hampton, Kim Jackson, Ewa Jaraczewska, Rucha Gadgil and Aminat Abolade  

Top Contributors - Alan Jit Ho Mak, Jess Bell, Tarina van der Stockt, Lucinda hampton, Kim Jackson, Ewa Jaraczewska, Rucha Gadgil and Aminat Abolade  

Introduction[edit | edit source]

Physiotherapy is defined as the therapeutic use of physical agents / means (i.e. massage or exercises) to treat disease / injury. This has been shown to be an extremely useful adjunct to medicine, human and veterinary.[1] The primary purpose of physiotherapy is to restore mobility / function and quality of life to patients.

This is often done by stimulating the healing process to restore injured tissues, to improve the balance / strength of the injured tissues and to stabilise the cardiorespiratory, neurological and musculoskeletal systems. Physiotherapy also has an important role in optimising performance and injury prevention in sporting and working animals. Animal physiotherapy is an emerging field[2] and it can be performed on any animal, but the vast majority of cases seen in small animal practice are dogs.[3]

PA dog walking.jpg

History[edit | edit source]

The first record of animal physiotherapy being practised comes from 1939 when Lord Mountbatten asked the Royal physiotherapist, Sir Charles Strong, to treat his horses.[4] Work in this field evolved from this point on. The first official animal physiotherapy association, the Association of Chartered Physiotherapists in Animal Therapy (ACPAT), was formed in the United Kingdom in 1985[5] and in 2011, animal physiotherapy was recognised as an official subgroup of the World Confederation of Physical Therapy (WCPT).[4]

Transferring knowledge of human physiotherapy to other species[edit | edit source]

In order for physiotherapists to be able to successfully transfer their assessment and treatment skills to animals, there must be sufficient similarities in structure, function and physiology across species.[4] There is a growing evidence base to support the notion that these similarities exist. For example:

  • It has been found that the disease progression of osteochondrosis is similar in humans, horses and pigs. There are similar:[6]
    • Clinical presentations
    • Changes on MRI and x-ray
    • Histological appearance of the end-stage lesion
    • Locations affected
  • Spontaneous canine cancers have a similar pathophysiology and clinical presentatison to the equivalent human cancers[7]

Moreover, some knowledge relevant to human physiotherapy has come from animal research. Horses are considered to be appropriate models for research on osteoarthritis of the knee.[4] Dogs are the animal model of choice for total hip joint replacements.[8]

The Role and Scope of Animal Physiotherapists[edit | edit source]

Animal physiotherapy is continuing to grow and develop as a profession. Animal physiotherapists work alongside a multidisciplinary team, just as they do in human physiotherapy. However, in most countries, animal physiotherapists do not have first-line practitioner status. They generally work on referral from a veterinarian.[2] Thus, there is a legal obligation to communicate with the veterinarian who is in charge of managing the patient.

There also needs to be a positive relationship with the animal’s carers. In the case of horses, this may be a large group, including the horse’s owner, rider, trainer, riding instructor, grooms and stableyard manager. There tends to be fewer carers involved in small animal care, but it is still important that each carer’s role in looking after the pet is understood.[4]

NB: There are different legal frameworks for animal physiotherapy across the world. If you are interested in this area of practice, it is essential to understand the legal requirements to practise this sort of physiotherapy in your country.[4]

Physiotherapy can be beneficial for animals with a wide range of conditions. It is often indicated post-operatively to correct complications that can occur as a result of surgery. The demand for post-operative animal physiotherapy has kept pace with the growing number of surgical options for small animal patients.[2]

Like conventional physiotherapy, animal physiotherapy is divided into a wide variety of specialities. In veterinary medicine, the divisions are:[9]

  • Musculoskeletal
  • Respiratory
  • Orthopaedics
  • Neurological
  • Sports medicine
  • Elderly care / geriatrics

Musculoskeletal[edit | edit source]

Most people consider this as 'traditional physiotherapy'. The conditions seen can be split into soft-tissue injuries, such as sprains / strains or ruptures of ligaments, tendons or muscles; bursitis and bone or joint disease, such as osteochondritis dissecans. The injuries may be a result of either a traumatic event or overuse, where the owner cannot recall the specific onset of symptoms.[10]

Respiratory[edit | edit source]

This encompasses the acute care of animals in a hospital, specifically for:

  • post-anaesthetic recovery
  • ventilated animals

Physiotherapy aims at managing secretions, preventing pressure sores, preventing atelectasis, reducing the work of breathing and optimising the ventilation / perfusion ratio to ensure high oxygen saturation levels.[11]

These aims are achieved through positioning (for pressure relief, postural drainage or to influence ventilation / perfusion ratio within the lungs), manual techniques such as percussion or vibrations to remove secretions, neuromuscular techniques such as rib springing to increase lung capacity and manual hyperinflation or bagging to improve ventilation and to aid secretion removal.

Orthopaedics[edit | edit source]

Physiotherapy following surgery is used to maximise the success of the surgery. By working with the surgeon, the recovery can be optimised. Orthopaedic surgeons may have their own protocols for rehabilitation following surgery and knowledge of these protocols is needed by the owner and therapist before embarking on a rehabilitation programme. These protocols guide the therapist on how much weight can be put through the leg and when different exercises can be introduced.[12]

Neurological[edit | edit source]

Neurological physiotherapy refers to the rehabilitation of animals following a neurological injury, which can involve a single limb or the whole body. Neurological damage can be managed conservatively or surgically. It may completely resolve or can leave lasting damage.[12]

The amount of initial damage usually has a significant impact on the ultimate recovery. Long-term solutions to permanent damage sometimes have to be sought, such as using wheels, harnesses / splints, to support the animal's everyday activities.

Sports medicine[edit | edit source]

The preparation of an animal for athletic activity is extremely important and requires physical training, skill training and cardiovascular training. Modalities that reduce recovery time and encourage a return to full fitness are considered vital to protect what are considered “valuable assets”.[13]

Animal physiotherapists can help to guide owners on conditioning programmes that are both sports- and animal specific. Different sports will place very different demands on animals. For instance, the endurance capability of a sled dog is very different to the speed of a racing greyhound. The rehabilitation of sports injuries is also extremely important as often these animals are not lame, but subtle changes in muscle tightness can affect their performance.

Elderly care / geriatrics[edit | edit source]

As pets (and owners) are living longer, there are increasing numbers of arthritic animals presenting for treatment. These animals often have other co-morbidities, such as diabetes, that can complicate the rehabilitation process. [14] A holistic management approach will help to ensure that these animals can stay comfortable and functional for longer.

Developmental problems[edit | edit source]

A large number of young animals are seen with genetic / developmental problems, and they benefit greatly from physiotherapy to support their joints. Conditions such as hip and elbow dysplasia are often seen. Physiotherapy, including hydrotherapy,[15] can improve their quality of life and prevent further problems or surgeries such as total hip replacements.

Evidence to Support the Use of Physiotherapy in Animals[edit | edit source]

While there are not many well-designed studies to support the use of physiotherapy in animals, massage is one area that has been researched in more detail. It has been proposed that due to similarities in physiology and anatomy between humans and dogs and cats, massage may also benefit animals:[16]

  • Manual lymph drainage has been found to reduce experimentally-induced lymphoedema in rats when compared to a control group[4]
  • Massaging the caudal thigh muscles of horses increases range of motion when compared to a sham treatment[17]
  • The use of relaxing massage may help to calm and relax racehorses and improve race performance[18]

Differences between humans and animals[edit | edit source]

Despite the similarities between humans and animals discussed above, there are also important differences (i.e. quadruped vs biped). It is important to understand the comparative anatomy and biomechanics of each species in order to determine the best treatment option.[4] 

Pathogenesis can be different even in shared pathologies or dysfunctions:

  • In humans, cruciate ligament ruptures are an acute injury more common in athletes, but in dogs they are the result of chronic disease processes.[19] Therefore, post-operative rehabilitation occurs in the context of chronic deconditioning[4]
  • In humans, there are dynamic fluctuations in intervertebral disc disease, but in dogs (particularly chondrodystrophic (i.e. short legged phenotype) dogs like dachshunds), the disc calcifies and if disc material extrudes, surgery is almost always recommended[4]

Human-Animal Dyad[edit | edit source]

The human-animal dyad refers to the relationship between a human caregiver and the animal. This can mimic a parent-child relationship. The dog–human attachment bond, for instance, is said to include all four features of attachment bonds that arise in human caregiver–infant relationships:[20]

  • Proximity seeking
  • Separation related distress
  • Safe-haven effect
  • Secure base effect

When assessing animal patients, it is important to remember that all of the information about an animal comes directly from the owner, even when using validated pain measures. The carer's own personality traits and emotions can have a significant impact on the animal.[4]

In the context of chronic pain, neuroticism is associated with pain catastrophising and higher pain-related anxiety. If animal cares are unable to modulate their own stress levels, they are more likely to catastrophise about their animal’s pain levels or disability.[4] Pain neuroscience education for the owner, therefore, plays an important role in treatment of the animal.[4]

In the case of horses, research shows that there is a high degree of emotional contagion. Emotional contagion is defined as: “the phenomenon of an automatic adoption of an emotional state of another person”.[21] In the context of animal physiotherapy, it refers specifically to the animal reflecting the emotional state of conspecifics (a member of the same species), or of other animals / individuals in their environment.[4] Horses have been found to demonstrate emotional contagion when observing human-horse interactions.[22]

Understanding these relationships, as well as having an awareness of animal behaviour enables the physiotherapist to approach and handle animal patients in a safe and effective way.[4]

Summary[edit | edit source]

  • Animal physiotherapy is growing as a profession
  • Research is limited at present, but there is evidence of sufficient interspecies similarities to support the use of human techniques on animals
  • Physiotherapy can be beneficial to all animals, but the choice of treatment can be limited by the presence of co-morbidities
  • The behaviour of an animal, the level of understanding of the owner and their emotions can all influence the success of the physiotherapy treatment

References[edit | edit source]

  1. ↑ McGowan CM, Stubbs NC, Jull GA. Equine physiotherapy: a comparative view of the science underlying the profession. Equine veterinary journal. 2007 Jan;39(1):90-4.
  2. ↑ 2.0 2.1 2.2 McGowan CM. Introduction. In: McGowan CM, Goff L editors. Animal Physiotherapy: Assessment, Treatment and Rehabilitation of Animals. Wiley-Blackwell, 2016. p.1-2
  3. ↑ Hayes-Davies D. Physiotherapy for the sporting dog. Companion Animal. 2014 Aug 2;19(8):415-22.
  4. ↑ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 4.10 4.11 4.12 4.13 4.14 Van Der Walt, A. Introduction to Animal Physiotherapy Course. Physioplus, 2021.
  5. ↑ Veenman P. Animal physiotherapy. Journal of Bodywork and Movement Therapies. 2006; 10(4): 317-27.
  6. ↑ McCoy AM, Toth F, Dolvik NI, Ekman S, Ellermann J, Olstad K et al. Articular osteochondrosis: a comparison of naturally-occurring human and animal disease. Osteoarthritis Cartilage. 2013; 21(11): 1638-47.
  7. ↑ Schiffman JD, Breen M. Comparative oncology: what dogs and other species can teach us about humans with cancer. Philos Trans R Soc Lond B Biol Sci. 2015; 370(1673): 20140231.
  8. ↑ Skurla CP, Pluhar GE, Frankel DJ, Egger EL, James SP. Assessing the dog as a model for human total hip replacement. Analysis of 38 canine cemented femoral components retrieved at post-mortem. J Bone Joint Surg Br. 2005; 87(1): 120-7
  9. ↑ Price H. Introduction to veterinary physiotherapy. Companion Animal. 2014; 19(3): 130-3.
  10. ↑ Goff L, Crook T. Physiotherapy assessment for animals. Animal physiotherapy, assessment, treatment and rehabilitation of animals. UK: Blackwell Publishing. 2007 Jan 1:136-63.
  11. ↑ Rivière S. Physiotherapy for cats and dogs applied to locomotor disorders of arthritic origin. Veterinary Focus. 2007;17(3):32-6.
  12. ↑ 12.0 12.1 Colveiro AC, Rauber JS, Ripplinger A, Wrzesinski M, Schwab ML, Pigatto A, Ferrarin DA, Mazzanti A. Neurological and Orthopedic Diseases in Dogs and Cats Submitted to Physiotherapy. Acta Scientiae Veterinariae. 2020 Oct 13;48.
  13. ↑ Doyle A, Horgan NF. Perceptions of animal physiotherapy amongst Irish veterinary surgeons. Ir Vet J. 2006; 59(2): 85-89.
  14. ↑ Cottriall S. The geriatric canine and physiotherapy. Companion Animal. 2014; 19: 296-300.
  15. ↑ Preston T, Wills AP. A single hydrotherapy session increases range of motion and stride length in Labrador retrievers diagnosed with elbow dysplasia. The Veterinary Journal. 2018; 234: 105-10.
  16. ↑ Corti L. Massage therapy for dogs and cats. Top Companion Anim Med. 2014; 29(2): 54-7.
  17. ↑ Hill C, Crook T. The relationship between massage to the equine caudal hindlimb muscles and hindlimb protraction. Equine Vet J Suppl. 2010; (38): 683-7.
  18. ↑ Kowalik S, Janczarek I, Kędzierski W, Stachurska A, Wilk I. The effect of relaxing massage on heart rate and heart rate variability in purebred Arabian racehorses. Anim Sci J. 2017; 88(4): 669-77.
  19. ↑ Griffon DJ. A review of the pathogenesis of canine cranial cruciate ligament disease as a basis for future preventive strategies. Vet Surg. 2010; 39(4): 399-409.
  20. ↑ Payne E, Bennett PC, McGreevy PD. Current perspectives on attachment and bonding in the dog-human dyad. Psychol Res Behav Manag. 2015; 8: 71-9.
  21. ↑ Singer T, Tusche A. Understanding others: brain mechanisms of theory of mind and empathy. In: Glimcher PW, Fehr E editors. Neuroeconomics: Decision making and the brain. London: Elsevier, 2014. p.513-32
  22. ↑ Trösch M, Pellon S, Cuzol F, Parias C, Nowak R, Calandreau L et al. Horses feel emotions when they watch positive and negative horse-human interactions in a video and transpose what they saw to real life. Anim Cogn. 2020; 23(4): 643-53.
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